TY - JOUR
T1 - Predictors and outcomes of healthcare-associated infections in COVID-19 patients
AU - Kumar, Gagan
AU - Adams, Alex
AU - Hererra, Martin
AU - Rojas, Erine Raybon
AU - Singh, Vartika
AU - Sakhuja, Ankit
AU - Meersman, Mark
AU - Dalton, Drew
AU - Kethireddy, Shravan
AU - Nanchal, Rahul
AU - Guddati, Achuta Kumar
N1 - Publisher Copyright:
© 2020 The Authors
PY - 2021/3
Y1 - 2021/3
N2 - Introduction: Healthcare-associated infections (HAI) after viral illnesses are important sources of morbidity and mortality. This has not been extensively studied in hospitalized COVID-19 patients. Methods: This study included all COVID-19-positive adult patients (≥18 years) hospitalized between 01 March and 05 August 2020 at the current institution. The Centers for Disease Control and Prevention definition of HAI in the acute care setting was used. The outcomes that were studied were rates and types of infections and in-hospital mortality. Several multivariable logistic regression models were constructed to examine characteristics associated with development of HAI. Results: Fifty-nine (3.7%) of 1565 patients developed 140 separate HAIs from 73 different organisms: 23 were Gram-positive, 39 were Gram-negative and 11 were fungal. Patients who developed HAI did not have higher odds of death (OR 0.85, 95% CI 0.40–1.81, p = 0.69). HAIs were associated with the use of tocilizumab (OR 5.04, 95% CI 2.4–10.6, p < 0.001), steroids (OR 3.8, 95% CI 1.4–10, p = 0.007), hydroxychloroquine (OR 3.0, 95% CI 1.0–8.8, p = 0.05), and acute kidney injury requiring hemodialysis (OR 3.7, 95% CI 1.1–12.8, p = 0.04). Conclusions: HAI were common in hospitalized Covid-19 patients. Tocilizumab and steroids were associated with increased risk of HAIs.
AB - Introduction: Healthcare-associated infections (HAI) after viral illnesses are important sources of morbidity and mortality. This has not been extensively studied in hospitalized COVID-19 patients. Methods: This study included all COVID-19-positive adult patients (≥18 years) hospitalized between 01 March and 05 August 2020 at the current institution. The Centers for Disease Control and Prevention definition of HAI in the acute care setting was used. The outcomes that were studied were rates and types of infections and in-hospital mortality. Several multivariable logistic regression models were constructed to examine characteristics associated with development of HAI. Results: Fifty-nine (3.7%) of 1565 patients developed 140 separate HAIs from 73 different organisms: 23 were Gram-positive, 39 were Gram-negative and 11 were fungal. Patients who developed HAI did not have higher odds of death (OR 0.85, 95% CI 0.40–1.81, p = 0.69). HAIs were associated with the use of tocilizumab (OR 5.04, 95% CI 2.4–10.6, p < 0.001), steroids (OR 3.8, 95% CI 1.4–10, p = 0.007), hydroxychloroquine (OR 3.0, 95% CI 1.0–8.8, p = 0.05), and acute kidney injury requiring hemodialysis (OR 3.7, 95% CI 1.1–12.8, p = 0.04). Conclusions: HAI were common in hospitalized Covid-19 patients. Tocilizumab and steroids were associated with increased risk of HAIs.
KW - COVID-19
KW - Hydroxychloroquine
KW - Secondary infections
KW - Tocilizumab
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U2 - 10.1016/j.ijid.2020.11.135
DO - 10.1016/j.ijid.2020.11.135
M3 - Article
C2 - 33207271
AN - SCOPUS:85100019778
SN - 1201-9712
VL - 104
SP - 287
EP - 292
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
ER -
